Health Care:

School-Based Health Centers Can Expand Access for Children

HEHS-95-35: Published: Dec 22, 1994. Publicly Released: Dec 22, 1994.

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Pursuant to a congressional request, GAO reviewed the role of school-based health centers (SBHC) in expanding children's access to health care and the financial and other obstacles SBHC must overcome to launch and maintain their services.

GAO found that: (1) SBHC afford children easier access to needed health services by bringing providers to the children, furnishing free or low-cost services, and supplying the atmosphere of trust and confidentiality adolescents need; (2) SBHC do not provide all health services required by students and cannot reach adolescents who have dropped out of school; (3) a lack of stable financing is a major concern for SBHC, with some centers reporting insufficient funds to meet all children's service needs; (4) SBHC often have difficulty obtaining reimbursement from public and private insurers, including Medicaid; (5) SBHC have difficulty recruiting and retaining appropriately trained nurse practitioners and physician assistants; (6) community debates over the appropriateness of providing reproductive health services in SBHC have limited the centers' ability to meet some adolescents' health needs; (7) communities lack access to information on establishing new centers and solving problems at existing SBHC; (8) research measuring the impact of SBHC on students' health and education is sparse; and (9) although efforts to coordinate school health programs within the federal government have begun, the Department of Health and Human Services does not have a focal point to answer outside inquiries, provide technical assistance, or develop a research agenda.

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